Fox News doesn’t want veterans to “settle” for nurses
Several press pieces have reported on the U.S. Department of Veterans Affairs’ (VA) May 25 notice of a proposed rule that would enable advanced practice nurses (APRNs) in the VA system to provide care to the full scope of their abilities without physician “supervision,” in an effort to reduce wait times. Most of these pieces do not adequately represent the nursing perspective, but the most damaging we have seen is a June 1 Fox News report. The video, featuring correspondent Doug McKelway, includes statements that the rule change would “allow highly trained nurses to act as doctors, and even administer anesthesia without a doctor’s supervision,” which might mean that veterans would have to “settle” for seeing a nurse rather than a physician.
The segment appears to have been sparked by a June 1 press conference in Washington DC by physician anesthesiologists’ groups who object to the proposed change, and the video and written pieces give such physicians free rein to espouse their unsupported views, with no response from any nursing group. In fact, the American Association of Nurse Anesthetists (AANA) issued a powerful rebuttal on the same day as the press conference, as part of a press release about the latest study showing that nurse anesthetists (CRNAs) are just as safe with physician “supervision” as they are without it. But instead of consulting the AANA, the Fox News reports found it sufficient to include quotes from former American Society of Anesthesiologists (ASA) president Jane Fitch, who basically argued that the move would endanger veterans because anesthesologists have longer training; current ASA president Daniel Cole, who argued that the rule change was unnecessary because there was no shortage of anesthesiologists at the VA; and U.S. Representative David Jolly (R-Fla.) who was reportedly “outraged” by the change. The piece did note that expanded APRN authority is a “trend,” quoting the VA’s Federal Register notice to the effect that CRNAs have full practice authority in 17 states, with nurse practitioners (NPs) having it in almost half the nation. And the video version of the piece did include a brief clip with an NP assuring us somewhat vaguely that APRNs do have clinical experience. But the piece failed to convey that CRNAs are graduate-prepared nurses with years of education specifically aimed at this work, which they have been doing safely for decades–they are not suddenly being asked to give anesthesia after having gone to a couple night school classes. In fact, there as many CRNAs as physician anesthesia providers in the U.S. and they provide care that is at least as good as physician anesthesia care.
More generally, CRNAs and other APRNs do not want to act like or be physicians. They have independent licenses and a unique scope of practice, under an autonomous nursing model that is broader and more holistic than the medical model. We urge Fox News to apologize for its unbalanced report, including the insulting suggestions that patients would be “settling” and that the nurses would be “act[ing] as doctors,” and to make amends by running a followup with AANA president Juan Quintana, RN, DNP (right), himself a military veteran. His rebuttal of the physicians’ claims in the June 1 AANA press release was forceful, noting that because the physicians “don’t have any evidence of their own to support their arguments, their actions are really quite reckless and selfishly put our nation’s veterans in a most precarious position.”
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